Public vs. private insurance: Cost, use, accessibility, and outcomes of services for children with autism spectrum disorders

Very little research has been conducted on insurance type (private vs. public funded) and costs, accessibility, and use of services of children with autism. Analysis of five parent reported outcomes: (a) out-of-pocket expenditures, (b) variety of services used, (c) access to services, (d) child and family service outcomes, and (e) satisfaction with payer of services against private and public insurance was completed. Parents/caregivers completed a survey regarding recent usage of nine specific services—inpatient care, medication management, counseling or training, individual therapy, in-home behavior therapy, speech and language therapy, occupational therapy, case management, and respite care. Across all respondents (n = 107), 73.5% were privately insured; 21.2% were publicly insured. Based on insurance type, no statistically significant differences in outcome variables were found, findings that were not consistent with previous research. However, an indirect association was found between out-of-pocket expense and parent satisfaction with the payer of services, access to care, and family outcomes. Further, a significantly higher percentage of total out-of-pocket expenditures were allocated to speech language therapy among publicly insured children than among privately insured children (p = .03) and parent stress was a moderating variable between access to care and variety of services used.